Abigail Pearse

Abigail works as a family and children lawyer in our Manchester office. She talks about her diagnosis of postural orthostatic tachycardia syndrome (PoTs) and how this affects her in the workplace.

illustration for Abigail Pearse

Tell us about your career at Mills & Reeve so far

I started my training contract in our Cambridge office where I sat with the real estate team. In the remainder of my first year, I completed seats in family, private client and projects. I was then given the opportunity to do a family seat in our Manchester office. I completed the entirety of my second year in Manchester, undertaking a seat in corporate and a further seat in family. I qualified into the family NSL in September 2020. 

There have been challenges on the training contract, I have learnt an incredible amount about the Mills & Reeve client base and work type, but I have also learnt a lot about my health along the way. Mills & Reeve was really supportive throughout my training contract, and particularly following my diagnosis of postural orthostatic tachycardia syndrome (PoTs) - a specific type of dysautonomia - in August 2020.

Can you tell us a little bit about dysautonomia? 

From the age of around 18, I've suffered from autonomic dysfunction, which is often coined as dysautonomia - an umbrella term that describes various medical conditions. Specifically, I struggle to regulate my autonomic nervous system (the system which controls one's heart rate, blood pressure, digestion, and temperature, among other things). I have specific conditions called neurocardiogenic syncope (NCS) and, as mentioned earlier, postural orthostatic tachycardia syndrome (PoTs).  

Dysautonomia can occur at any stage of someone’s life and it's quite common to take years to receive a formal diagnosis (it took six years to receive mine) due to the difficulty in pinpointing what is causing one’s health problems and the general misunderstanding surrounding autonomicdysfunction.

Unfortunately, there's no cure for dysautonomia. Some people do grow out of it (usually in their late teenage years), but ultimately, once you receive the diagnosis, it's a case of learning to manage your symptoms (whether via salt and fluid hydration, medication or other methods).   

What are the symptoms and impact on you?

I experience various symptoms as a result of my conditions, some more frequently than others. The most common symptoms associated with NCS and PoTs are dizziness, abnormal heart rate, light-headedness, the inability to stand for prolonged periods, unstable blood pressure, brain fog and fainting. 

My flare ups happen in specific situations most often, but sometimes, they can appear randomly and unexpectedly. Often, however, my triggers are when I exercise (cardio confuses my system), when I stand up on public transport, when I'm unwell for other reasons and when the temperature is warm. Some days I feel as right as rain, but others, it's very much a struggle to get up and about.  

One of the hardest things about the condition is that it can come on randomly at any moment, so I might be absolutely fine at 9am, but by 4pm, I could be feeling incredibly unwell. I’m learning more and more about my body and health as the months go on, and though this condition is incredibly frustrating, my ability to manage it and achieve what I have done makes me feel very proud of myself. 

What about dysautonomia in the workplace? How has Mills & Reeve supported you?

I didn’t actually have my formal diagnosis when I started my training contract at Mills & Reeve, I was under medical investigation for years but I didn’t really know how to explain my health to people. For a while I tried to keep it off the radar, but when this became difficult to do because of flare ups, I realised that I needed to be more open about my health. The Ability Network, the firm’s disability and neurodiversity working group, helped me to establish the confidence to talk openly about my health and for that I am very grateful. 

In the last year of my training, I had a heart monitor fitted in February and took some time off to try and control my symptoms. I was so grateful to have the support of my colleagues throughout. From the partner in my team calling frequently to speak to me on a 1-1 basis about my wellbeing, to the Ability network (of which I'm now a co-chair) normalising health conditions in the workplace, I began to feel confident and honest in talking about how I was feeling. I'm particularly grateful for every member of my team as they consciously make an effort to check in on me and encourage me to be open about how I'm feeling to ensure that I'm supported as best as I can be in the workplace. 

I've always been made to feel that my health is a priority and have frequently been reminded that there is an abundance of support available to me, including the ability to work from home if needed. I look forward to contributing further to the Ability Network to help Mills & Reeve continue to thrive in being an accessible and diverse workplace. 

What's your best piece of advice for trainees starting at Mills & Reeve

Be as open and honest as you comfortably can be. It's really quite daunting dealing with a medical concern or something in your life that may affect your performance at work, and it's even more daunting to admit to it and be open about it. Ultimately, what I've learnt is that to receive the support that Mills & Reeve are very happy to provide, you need to be brave enough to seek the support. You have been given a training contract on the basis of your ability – any extenuating factors should not deter you from that success. If you're too nervous to discuss your situation with HR / your seat supervisor, reach out to the Ability network, or myself, and you'll be on the path to getting the support that you deserve. 

Learn more about PoTs or dysautonomia here.